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Kang DH, Kim MJ, Mohamed EA, Kim DS, Jeong JS, Kim SY, Kang HG, Lee GS, Hong EJ, Ahn C, Jung EM, An BS, Kim SC. Regulation of uterus and placenta remodeling under high estradiol levels in gestational diabetes mellitus models†. Biol Reprod 2023; 109:215-226. [PMID: 37255320 DOI: 10.1093/biolre/ioad059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 04/25/2023] [Accepted: 05/18/2023] [Indexed: 06/01/2023] Open
Abstract
The present study aimed to investigate the regulation of placentas and uterus remodeling and involvement of estradiol in gestational diabetes mellitus. To achieve this, we established in vitro and in vivo models for gestational diabetes mellitus placentas by culturing human placental choriocarcinoma cells (BeWo) under hyperglycemic concentration and treating pregnant rats with streptozotocin. We evaluated the expression of angiogenesis-related proteins. The expression of the anti-angiogenic factor, excess placental soluble fms-like tyrosine kinase 1 was increased in our in vitro gestational diabetes mellitus model compared with the control. Moreover, the expressions of placental soluble fms-like tyrosine kinase 1 and the von Willebrand factor were also significantly elevated in the placenta of streptozotocin-treated rats. These data indicate the disruption of angiogenesis in the gestational diabetes mellitus placentas. The expression levels of connexin 43, a component of the gap junction and collagen type I alpha 2 chain, a component of the extracellular matrix, were decreased in the gestational diabetes mellitus uterus. These results suggest that uterus decidualization and placental angiogenesis are inhibited in gestational diabetes mellitus rats. Our results also showed upregulation of the expression of genes regulating estradiol synthesis as well as estrogen receptors in vivo models. Accordingly, the concentration of estradiol measured in the culture medium under hyperglycemic conditions, as well as in the serum and placenta of the streptozotocin-treated rats, was significantly elevated compared with the control groups. These results suggest that the dysregulated remodeling of the placenta and uterus may result in the elevation of estradiol and its signaling pathway in the gestational diabetes mellitus animal model to maintain pregnancy.
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Affiliation(s)
- Da Hee Kang
- Department of Biomaterials Science (BK21 Four Program), College of Natural Resources & Life Science, Pusan National University, Miryang, Republic of Korea
| | - Min Jae Kim
- Department of Biomaterials Science (BK21 Four Program), College of Natural Resources & Life Science, Pusan National University, Miryang, Republic of Korea
- Developmental and Reproductive Toxicology Research Group, Korea Institute of Toxicology, Daejeon, Republic of Korea
| | - Elsayed A Mohamed
- Department of Biomaterials Science (BK21 Four Program), College of Natural Resources & Life Science, Pusan National University, Miryang, Republic of Korea
- Department of Genetics, Assiut University, Assiut, Egypt
| | - Da Som Kim
- Department of Biomaterials Science (BK21 Four Program), College of Natural Resources & Life Science, Pusan National University, Miryang, Republic of Korea
| | - Jea Sic Jeong
- Department of Biomaterials Science (BK21 Four Program), College of Natural Resources & Life Science, Pusan National University, Miryang, Republic of Korea
| | - So Young Kim
- Department of Biomaterials Science (BK21 Four Program), College of Natural Resources & Life Science, Pusan National University, Miryang, Republic of Korea
| | - Hyeon-Gu Kang
- Department of Biomaterials Science (BK21 Four Program), College of Natural Resources & Life Science, Pusan National University, Miryang, Republic of Korea
| | - Geun-Shik Lee
- Department of Veterinary Medicine, Kangwon National University, Chuncheon, Gangwon, Republic of Korea
| | - Eui-Ju Hong
- Department of Veterinary Medicine, Chungnam National University, Daejeon, Republic of Korea
| | - Changhwan Ahn
- Department of Veterinary Medicine, Jeju National University, Jeju, Republic of Korea
| | - Eui-Man Jung
- Department of Molecular Biology, College of Natural Sciences, Pusan National University, Busan, Republic of Korea
| | - Beum-Soo An
- Department of Biomaterials Science (BK21 Four Program), College of Natural Resources & Life Science, Pusan National University, Miryang, Republic of Korea
| | - Seung-Chul Kim
- Department of Obstetrics and Gynecology, Pusan National University School of Medicine, Busan, Republic of Korea
- Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
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Lokki AI, Heikkinen-Eloranta J. Pregnancy induced TMA in severe preeclampsia results from complement-mediated thromboinflammation. Hum Immunol 2021; 82:371-378. [PMID: 33820656 DOI: 10.1016/j.humimm.2021.03.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 03/12/2021] [Accepted: 03/15/2021] [Indexed: 11/24/2022]
Abstract
Preeclampsia is a multifactorial vascular disease unique to human pregnancy. While genetic and antiangiogenic factors are important contributors to preeclampsia susceptibility, recent studies have shown that dysregulation and/or over-activation of the complement system has an integral role in disease etiology. Furthermore, the role of the coagulation cascade may be underappreciated in the development of the disease. Traditionally, for research purposes, the pool of preeclampsia cases has been divided into non-severe and severe disease depending on the onset and severity of the symptoms. However, of particular interest are a small but important minority of cases that present with symptoms likening to those of hemolysis, elevated liver enzymes and low platelets syndrome, atypical hemolytic uremic syndrome, or thrombotic thrombocytopenic purpura, all thrombotic microangiopathy (TMA) diseases, with the hallmark mechanisms of endothelial dysfunction and aberrant activation of complement and coagulation cascades. We therefore propose a third class, severe TMA-like preeclampsia to be included in the categorization of preeclampsia patients. Identifying these patients would target research, diagnostic differentiation, and novel treatment options to the subclass of patients with life-threatening disease that are most likely to benefit from next-generation drug development.
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Affiliation(s)
- A Inkeri Lokki
- Bacteriology and Immunology, University of Helsinki and Helsinki University Hospital, Translational Immunology Research Program, Research Programs' Unit, University of Helsinki, Helsinki, Finland; Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
| | - Jenni Heikkinen-Eloranta
- Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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Flores-Pliego A, Miranda J, Vega-Torreblanca S, Valdespino-Vázquez Y, Helguera-Repetto C, Espejel-Nuñez A, Borboa-Olivares H, Espino y Sosa S, Mateu-Rogell P, León-Juárez M, Ramírez-Santes V, Cardona-Pérez A, Villegas-Mota I, Torres-Torres J, Juárez-Reyes Á, Rizo-Pica T, González RO, González-Mariscal L, Estrada-Gutierrez G. Molecular Insights into the Thrombotic and Microvascular Injury in Placental Endothelium of Women with Mild or Severe COVID-19. Cells 2021; 10:cells10020364. [PMID: 33578631 PMCID: PMC7916402 DOI: 10.3390/cells10020364] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 01/30/2021] [Accepted: 02/03/2021] [Indexed: 02/07/2023] Open
Abstract
Clinical manifestations of coronavirus disease 2019 (COVID-19) in pregnant women are diverse, and little is known of the impact of the disease on placental physiology. Severe acute respiratory syndrome coronavirus (SARS-CoV-2) has been detected in the human placenta, and its binding receptor ACE2 is present in a variety of placental cells, including endothelium. Here, we analyze the impact of COVID-19 in placental endothelium, studying by immunofluorescence the expression of von Willebrand factor (vWf), claudin-5, and vascular endothelial (VE) cadherin in the decidua and chorionic villi of placentas from women with mild and severe COVID-19 in comparison to healthy controls. Our results indicate that: (1) vWf expression increases in the endothelium of decidua and chorionic villi of placentas derived from women with COVID-19, being higher in severe cases; (2) Claudin-5 and VE-cadherin expression decrease in the decidua and chorionic villus of placentas from women with severe COVID-19 but not in those with mild disease. Placental histological analysis reveals thrombosis, infarcts, and vascular wall remodeling, confirming the deleterious effect of COVID-19 on placental vessels. Together, these results suggest that placentas from women with COVID-19 have a condition of leaky endothelium and thrombosis, which is sensitive to disease severity.
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Affiliation(s)
- Arturo Flores-Pliego
- Department of Immunobiochemistry, Instituto Nacional de Perinatología, Ciudad de México 11000, Mexico; (A.F.-P.); (C.H.-R.); (A.E.-N.); (M.L.-J.)
| | - Jael Miranda
- Department of Physiology, Biophysics and Neuroscience, Center for Research and Advanced Studies (Cinvestav), Ciudad de México 07360, Mexico; (J.M.); (S.V.-T.)
| | - Sara Vega-Torreblanca
- Department of Physiology, Biophysics and Neuroscience, Center for Research and Advanced Studies (Cinvestav), Ciudad de México 07360, Mexico; (J.M.); (S.V.-T.)
| | | | - Cecilia Helguera-Repetto
- Department of Immunobiochemistry, Instituto Nacional de Perinatología, Ciudad de México 11000, Mexico; (A.F.-P.); (C.H.-R.); (A.E.-N.); (M.L.-J.)
| | - Aurora Espejel-Nuñez
- Department of Immunobiochemistry, Instituto Nacional de Perinatología, Ciudad de México 11000, Mexico; (A.F.-P.); (C.H.-R.); (A.E.-N.); (M.L.-J.)
| | - Héctor Borboa-Olivares
- Community Interventions Research Branch, Instituto Nacional de Perinatología, Ciudad de México 11000, Mexico;
| | - Salvador Espino y Sosa
- Clinical Research Branch, Instituto Nacional de Perinatología, Ciudad de México 11000, Mexico; (S.E.yS.); (P.M.-R.)
| | - Paloma Mateu-Rogell
- Clinical Research Branch, Instituto Nacional de Perinatología, Ciudad de México 11000, Mexico; (S.E.yS.); (P.M.-R.)
| | - Moisés León-Juárez
- Department of Immunobiochemistry, Instituto Nacional de Perinatología, Ciudad de México 11000, Mexico; (A.F.-P.); (C.H.-R.); (A.E.-N.); (M.L.-J.)
| | - Victor Ramírez-Santes
- Department of Obstetrics, Instituto Nacional de Perinatología, Ciudad de México 11000, Mexico;
| | - Arturo Cardona-Pérez
- General Direction, Instituto Nacional de Perinatología, Ciudad de México 11000, Mexico;
| | - Isabel Villegas-Mota
- Department of Epidemiology, Instituto Nacional de Perinatología, Ciudad de México 11000, Mexico;
| | - Johnatan Torres-Torres
- Hospital General de México Dr Eduardo Liceaga, Ciudad de México 06720, Mexico; (J.T.-T.); (Á.J.-R.); (T.R.-P.)
| | - Ángeles Juárez-Reyes
- Hospital General de México Dr Eduardo Liceaga, Ciudad de México 06720, Mexico; (J.T.-T.); (Á.J.-R.); (T.R.-P.)
| | - Thelma Rizo-Pica
- Hospital General de México Dr Eduardo Liceaga, Ciudad de México 06720, Mexico; (J.T.-T.); (Á.J.-R.); (T.R.-P.)
| | - Rosa O. González
- Department of Mathematics, Autonomous Metropolitan University-Iztapalapa (UAM-I), Ciudad de México 14387, Mexico;
| | - Lorenza González-Mariscal
- Department of Physiology, Biophysics and Neuroscience, Center for Research and Advanced Studies (Cinvestav), Ciudad de México 07360, Mexico; (J.M.); (S.V.-T.)
- Correspondence: (L.G.-M.); (G.E.-G.); Tel.: +5255-5-747-3800 (ext. 3966) (L.G.-M.); +5255-5-520-9900 (ext. 160) (G.E.-G.)
| | - Guadalupe Estrada-Gutierrez
- Research Division, Instituto Nacional de Perinatología, Ciudad de México 11000, Mexico
- Correspondence: (L.G.-M.); (G.E.-G.); Tel.: +5255-5-747-3800 (ext. 3966) (L.G.-M.); +5255-5-520-9900 (ext. 160) (G.E.-G.)
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Mathias M, Bitar M, Aldulescu M, Birkett R, Perez M, Mestan K. Placental vascular maldevelopment, intrauterine growth restriction, and pulmonary hypertension. Pulm Circ 2020; 10:2045894020970056. [PMID: 33282199 PMCID: PMC7691913 DOI: 10.1177/2045894020970056] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Accepted: 10/09/2020] [Indexed: 11/17/2022] Open
Abstract
A 33-year-old gravida 2, para 1 woman was noted to have early intrauterine growth
restriction at 22 weeks gestation and subsequently developed severe pre-eclampsia. She
delivered a 460 g male neonate at 28 weeks. The infant was managed on non-invasive
ventilatory support and was gaining weight on enteral feeds for the first eight weeks of
life, at which point he developed necrotizing enterocolitis. He then developed severe
pulmonary hypertension that was refractory to maximal medical management. He died at 10
weeks of life due to hypoxemic respiratory and heart failure. Placental pathology revealed
a constellation of findings consistent with maternal vascular malperfusion. Lung autopsy
revealed muscularized and hypertrophied pulmonary arterioles consistent with severe
pulmonary hypertension. Von Willebrand factor immunofluorescent staining of autopsy
specimens suggest parallels in extent of endothelial injury. This case study illustrates
our evolving knowledge of the fetal origins of neonatal lung diseases.
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Affiliation(s)
- Maxwell Mathias
- Division of Neonatology, Department of Pediatrics, Northwestern University Feinberg School of Medicine and Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | - Mireille Bitar
- Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Monica Aldulescu
- Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Robert Birkett
- Division of Neonatology, Department of Pediatrics, Northwestern University Feinberg School of Medicine and Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | - Marta Perez
- Division of Neonatology, Department of Pediatrics, Northwestern University Feinberg School of Medicine and Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | - Karen Mestan
- Division of Neonatology, Department of Pediatrics, Northwestern University Feinberg School of Medicine and Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
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Allerkamp H, Lehner S, Ekhlasi-Hundrieser M, Detering C, von Depka Prondzinski M, Pfarrer C. Expression of angiogenic factors in the uteroplacental unit is altered at time of placentation in a porcine model of von Willebrand disease type 1. Reprod Biol 2019; 19:412-420. [PMID: 31806575 DOI: 10.1016/j.repbio.2019.09.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Revised: 08/27/2019] [Accepted: 09/29/2019] [Indexed: 11/15/2022]
Abstract
Von Willebrand disease (VWD) affects blood coagulation and correlates with angiodysplasia. Data on VWD-affected women point to slightly increased miscarriage rates. We aimed to investigate the impact of VWD on angiogenesis in the uteroplacental unit of pregnant pigs of a model of VWD type 1 (T1). Uteri, placentae, and embryos were harvested at time of placentation (day 29 to 31) from four sows (two wildtype (WT) and two heterozygous for a von Willebrand factor (VWF) mutation diagnosed with T1). T1 sows were bred to a T1 boar creating embryos of three different genotypes: WT, T1 or homozygous for the VWF mutation corresponding with VWD type 3 (T3). Uteroplacental tissues were examined histologically. Embryos were genotyped. Gene expression of angiogenic factors possibly related to VWF was determined by quantitative real-time PCR. Corresponding protein expression was analyzed by immunohistochemistry. Genotyping revealed 35.3% WT, 52.9% T1 and 5.9% T3 embryos (5.9% not classified confidently). No histological alterations were found. Gene expression of VEGF was significantly increased in T1 placentae while expression of ANG1, ANG2, TIE2, and ITGB3 was significantly reduced, confirmed on protein level for different cell types. TIE2/TIE1 ratios were significantly lower in T1 placentae. Distribution of embryo genotypes indicates selection favoring the WT. Significant expression differences of angiogenic factors in placentae suggest influence of VWF on these factors during placentation, although angiodysplasia was not observed. The alterations concerning VEGF/VEGFR-2 signaling, integrin expression and the ANG/TIE system may influence angiogenesis and vascular adaptation during placentation and thus the overall outcome of pregnancy.
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Affiliation(s)
- Hanna Allerkamp
- Werlhof Institute, Department of Fundamental and Clinical Research, Schillerstr. 23, 30159 Hannover, Germany.
| | - Stefanie Lehner
- Werlhof Institute, Department of Fundamental and Clinical Research, Schillerstr. 23, 30159 Hannover, Germany
| | - Mahnaz Ekhlasi-Hundrieser
- Werlhof Institute, Department of Fundamental and Clinical Research, Schillerstr. 23, 30159 Hannover, Germany
| | - Carsten Detering
- Werlhof Institute, Department of Fundamental and Clinical Research, Schillerstr. 23, 30159 Hannover, Germany
| | - Mario von Depka Prondzinski
- Werlhof Institute, Department of Fundamental and Clinical Research, Schillerstr. 23, 30159 Hannover, Germany
| | - Christiane Pfarrer
- University of Veterinary Medicine Hannover Foundation, Institute for Anatomy, Bischofsholer Damm 15, 30173 Hannover, Germany
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Tanaka K, Nakabayashi K, Kawai T, Tanigaki S, Matsumoto K, Hata K, Kobayashi Y. Gene expression and DNA methylation changes in BeWo cells dependent on tumor necrosis factor-α and insulin-like growth factor-I. Hum Cell 2019; 33:37-46. [PMID: 31724103 DOI: 10.1007/s13577-019-00299-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Accepted: 10/23/2019] [Indexed: 01/12/2023]
Abstract
Pregnant women with increased insulin resistance, characterized by elevated levels of tumor necrosis factor-alpha (TNF-α) and insulin-like growth factor-I (IGF-I), are at high risk of preeclampsia. We hypothesized that TNF-α and IGF-I affect the placentas and cause pathological changes leading to preeclampsia. To understand the genetic and epigenetic effects of TNF-α and IGF-I on trophoblast cells, gene expression microarray and DNA methylation array of BeWo cells stimulated by TNF-α (100 pg/ml, 100 ng/ml) and IGF-I (100 ng/ml) were conducted. Microarray analysis revealed the differential gene expression patterns in BeWo cells co-stimulated by TNF-α and IGF-I. Enrichment analysis identified the terms associated with NF-kappa B signaling pathways and arachidonic acid cascades such as PTGS2 and PTGER2. DNA methylation array revealed the distinct CpG methylation pattern in BeWo cells stimulated by high-TNF-α and IGF-I, while neither of them showed independent effects. Enrichment analysis identified the terms associated with major histocompatibility complex proteins. Integration of transcriptome and DNA methylome analyses identified three differentially expressed genes with significant DNA methylation change: C3, GP1BA, and NFKBIE, which are all possibly associated with pathogenesis of preeclampsia. In conclusion, co-stimulation of TNF-α and IGF-I induced the genetic and epigenetic changes associated with preeclampsia in BeWo cells. The results suggested that BeWo cells stimulated by TNF-α and IGF-I is a good in vitro model of preeclamptic placenta in pregnancy with increased insulin resistance.
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Affiliation(s)
- Kei Tanaka
- Department of Obstetrics and Gynecology, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo, 181-8611, Japan.
| | - Kazuhiko Nakabayashi
- Department of Maternal-Fetal Biology, National Research Institute for Child Health and Development, 2-10-1 Okura, Setagaya, Tokyo, 157-8535, Japan
| | - Tomoko Kawai
- Department of Maternal-Fetal Biology, National Research Institute for Child Health and Development, 2-10-1 Okura, Setagaya, Tokyo, 157-8535, Japan
| | - Shinji Tanigaki
- Department of Obstetrics and Gynecology, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo, 181-8611, Japan
| | - Kenji Matsumoto
- Department of Allergy and Clinical Immunology, National Research Institute for Child Health and Development, 2-10-1 Okura, Setagaya, Tokyo, 157-8535, Japan
| | - Kenichiro Hata
- Department of Maternal-Fetal Biology, National Research Institute for Child Health and Development, 2-10-1 Okura, Setagaya, Tokyo, 157-8535, Japan
| | - Yoichi Kobayashi
- Department of Obstetrics and Gynecology, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo, 181-8611, Japan
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Mojiri A, Alavi P, Jahroudi N. Von Willebrand factor contribution to pathophysiology outside of von Willebrand disease. Microcirculation 2018; 26:e12510. [PMID: 30365187 DOI: 10.1111/micc.12510] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Revised: 10/12/2018] [Accepted: 10/19/2018] [Indexed: 12/13/2022]
Abstract
VWF is a procoagulant protein that plays a central role in the initiation of platelets aggregate formation and thrombosis. While von Willebrand disease has long been known to result from qualitative and quantitative deficiencies of VWF, it is recently that contribution of elevated levels of VWF to various pathological conditions including thrombosis, inflammation, angiogenesis, and cancer metastasis has been appreciated. Here, we discuss contribution of elevated levels of VWF to various thrombotic and nonthrombotic pathological conditions.
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Affiliation(s)
- Anahita Mojiri
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Parnian Alavi
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Nadia Jahroudi
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
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Göksever Çelik H, Uhri M, Yildirim G. Expression of von Willebrand factor and caldesmon in the placental tissues of pregnancies complicated with intrauterine growth restriction. J Matern Fetal Neonatal Med 2017; 32:916-921. [PMID: 29046106 DOI: 10.1080/14767058.2017.1395017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
PURPOSE The decreased placental perfusion is the underlying reason for intrauterine growth restriction that in turn leads to reduced placental perfusion and ischemia. However, there are several issues to be understood in the pathophysiology of intrauterine growth restriction. We aimed to study whether any compensatory response in placental vascular bed occur in pregnancies complicated with intrauterine growth restriction by the immunohistochemical staining of von Willebrand factor and caldesmon in placental tissues. MATERIALS AND METHODS A total of 103 pregnant women was enrolled in the study including 50 patients who were complicated with IUGR and 50 uncomplicated control patients. The study was designed in a prospective manner. All placentas were also stained with von Willebrand factor and caldesmon monoclonal kits. RESULTS The immunohistochemical staining of von Willebrand factor and caldesmon expressions in placental tissues were different between normal and intrauterine growth restriction group. The percentages of 2+ and 3+ von Willebrand factor expression were higher in the intrauterine growth restriction group comparing with the normal group, although the difference was not statistically significant. The intensity of caldesmon expression was significantly lower in the intrauterine growth restriction group in comparison with the normal group (p < .001). CONCLUSION Angiogenesis occurs as a placental response to intrauterine growth restriction which is a hypoxic condition. But newly formed vessels are immature and not strong enough. Our study is important to clarify the pathophysiology and placental compensatory responses in intrauterine growth restriction.
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Affiliation(s)
- Hale Göksever Çelik
- a Department of Obstetrics and Gynecology , Istanbul Saglik Bilimleri University Kanuni Sultan Suleyman Training and Research Hospital , Istanbul , Turkey
| | - Mehmet Uhri
- b Department of Pathology , Istanbul Saglik Bilimleri University Kanuni Sultan Suleyman Training and Research Hospital , Istanbul , Turkey
| | - Gökhan Yildirim
- a Department of Obstetrics and Gynecology , Istanbul Saglik Bilimleri University Kanuni Sultan Suleyman Training and Research Hospital , Istanbul , Turkey
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Ohshima M, Coq JO, Otani K, Hattori Y, Ogawa Y, Sato Y, Harada-Shiba M, Ihara M, Tsuji M. Mild intrauterine hypoperfusion reproduces neurodevelopmental disorders observed in prematurity. Sci Rep 2016; 6:39377. [PMID: 27996031 PMCID: PMC5171836 DOI: 10.1038/srep39377] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Accepted: 11/23/2016] [Indexed: 12/17/2022] Open
Abstract
Severe intrauterine ischemia is detrimental to the developing brain. The impact of mild intrauterine hypoperfusion on neurological development, however, is still unclear. We induced mild intrauterine hypoperfusion in rats on embryonic day 17 via arterial stenosis with metal microcoils wrapped around the uterine and ovarian arteries. All pups were born with significantly decreased birth weights. Decreased gray and white matter areas were observed without obvious tissue damage. Pups presented delayed newborn reflexes, muscle weakness, and altered spontaneous activity. The levels of proteins indicative of inflammation and stress in the vasculature, i.e., RANTES, vWF, VEGF, and adiponectin, were upregulated in the placenta. The levels of mRNA for proteins associated with axon and astrocyte development were downregulated in fetal brains. The present study demonstrates that even mild intrauterine hypoperfusion can alter neurological development, which mimics the clinical signs and symptoms of children with neurodevelopmental disorders born prematurely or with intrauterine growth restriction.
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Affiliation(s)
- Makiko Ohshima
- Department of Regenerative Medicine and Tissue Engineering, National Cerebral and Cardiovascular Center, Osaka 565-8565, Japan
| | - Jacques-Olivier Coq
- Institut de Neurosciences de la Timone, UMR7289, CNRS, Aix Marseille Université, Marseille 13005, France
| | - Kentaro Otani
- Department of Regenerative Medicine and Tissue Engineering, National Cerebral and Cardiovascular Center, Osaka 565-8565, Japan
| | - Yorito Hattori
- Department of Regenerative Medicine and Tissue Engineering, National Cerebral and Cardiovascular Center, Osaka 565-8565, Japan
| | - Yuko Ogawa
- Department of Regenerative Medicine and Tissue Engineering, National Cerebral and Cardiovascular Center, Osaka 565-8565, Japan
| | - Yoshiaki Sato
- Division of Neonatology, Center for Maternal-Neonatal Care, Nagoya University Hospital, Nagoya 466-8550, Japan
| | - Mariko Harada-Shiba
- Department of Regenerative Medicine and Tissue Engineering, National Cerebral and Cardiovascular Center, Osaka 565-8565, Japan
| | - Masafumi Ihara
- Department of Stroke and Cerebrovascular Diseases, National Cerebral and Cardiovascular Center, Osaka 565-8565, Japan
| | - Masahiro Tsuji
- Department of Regenerative Medicine and Tissue Engineering, National Cerebral and Cardiovascular Center, Osaka 565-8565, Japan
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Bosco C, Díaz E. Presence of Telocytes in a Non-innervated Organ: The Placenta. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2016; 913:149-161. [PMID: 27796886 DOI: 10.1007/978-981-10-1061-3_10] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
This chapter discusses the relationship between failure in placentation and the subsequent alterations in the normal structure of the placenta. Interstitial Cajal-like cells (ICLC) were observed for the first time in the human placenta in 2007 and later were named telocytes. Strong evidence confirms that in the placental chorionic villi, TC are located strategically between the smooth muscle cells (SMC) of the fetal blood vessel wall and the stromal myofibroblasts. As the placenta is a non-innervated organ and considering the strategic position of telocytes in chorionic villi, it has been postulated that their function would be related to signal transduction mechanisms involved in the regulation of the blood flow in the fetal vessels, as well as in the shortening/lengthening of the chorionic villi providing the necessary rhythmicity to the process of maternal/fetal metabolic exchange. In this context, telocytes represent part of a functional triad: "SMC of fetal blood vessel-telocyte-myofibroblast." This triad takes part in the regulation of fetal growth and development via transport of nutrients and gases. This chapter also discusses the alterations in the metabolic maternal-fetal exchange, leading to intrauterine growth retardation and preeclampsia. Additionally, the apoptosis undergoing in the preeclamptic hypoxic placenta affects all the chorionic villi cells, including telocytes and myofibroblast, and not only trophoblast, as it has been so far considered. In consequence, we proposed that apoptosis affects the triad structure and alters the placental function, subsequently affecting the normal fetal growth and development.
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Affiliation(s)
- Cleofina Bosco
- Laboratorio de Placenta y Desarrollo Fetal, Anatomy and Developmental Biology Program, Institute of Biomedical Sciences, Faculty of Medicine, University of Chile, Independencia 1027, Casilla, Santiago 7, 70079, Chile.
| | - Eugenia Díaz
- Anatomy and Developmental Biology Program, Institute of Biomedical Sciences, Faculty of Medicine, University of Chile, Santiago, Chile
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Wu F, Tian FJ, Lin Y, Xu WM. Oxidative Stress: Placenta Function and Dysfunction. Am J Reprod Immunol 2015; 76:258-71. [PMID: 26589876 DOI: 10.1111/aji.12454] [Citation(s) in RCA: 110] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2015] [Accepted: 10/20/2015] [Indexed: 12/26/2022] Open
Abstract
During pregnancy, the placenta is a site of active oxygen metabolism that continuously generates oxidative stress (OS). Overproduction of reactive oxygen species and reactive nitrogen species can destroy normal placental functions. Therefore, the feto-placental unit generates abundant antioxidants to keep OS under control. Properly controlled oxidative species have been proven to serve as indispensable cellular signal messengers by regulating gene expression and downstream cellular activities. OS also plays an important immunoregulatory role during pregnancy. Oxidative disorder and immune disturbances are associated with adverse pregnancy outcomes such as spontaneous abortion, preeclampsia and intrauterine growth restriction. In this review, we introduce recent studies revealing basal functions and regulatory roles of placental OS in metabolism and immunity. The relationships between OS- and pregnancy-related disorders are also discussed.
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Affiliation(s)
- Fan Wu
- Institute of Embryo-Fetal Original Adult Disease, the International Peace Maternity & Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Fu-Ju Tian
- Institute of Embryo-Fetal Original Adult Disease, the International Peace Maternity & Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yi Lin
- Institute of Embryo-Fetal Original Adult Disease, the International Peace Maternity & Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wang-Ming Xu
- Reproductive Medicine Center, Renmin Hospital of Wuhan University, Wuhan, China.
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A putative role for telocytes in placental barrier impairment during preeclampsia. Med Hypotheses 2014; 84:72-7. [PMID: 25499002 DOI: 10.1016/j.mehy.2014.11.019] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2014] [Accepted: 11/22/2014] [Indexed: 02/04/2023]
Abstract
Preeclampsia (PE) is a major health problem occurring in pregnant women and the principal cause of maternal morbidity and perinatal mortality. It is characterized by alteration of the extravilli trophoblast cell migration toward the endometrial spiral arteries with a concomitant reduction in maternal blood flow in the placenta. This result in a state of ischemia-hypoxia which triggers an oxidative stress stage with production of reactive oxygen species. A cascade of cellular and molecular events leads then to endothelial dysfunction, transduction pathway signal disruption and induction of apoptosis and necrosis mechanisms and therefore a significant reduction in the amount of nutrients required for normal fetal development. Placental anchoring chorionic and stem villi present a skeleton of myofibroblasts arranged in parallel disposition to its longitudinal axis. The intraplacental blood volume is controlled by the contraction/relaxation of these myofibroblasts, promoting the delivery of nutrients and metabolites to the fetus. Recently, a new mesodermal originated cell type has been described in the villous stroma, the so named "telocytes". These cells are strategically located between the smooth muscle cells of the blood vessel wall and the myofibroblasts, and it is reasonable to hypothesize that they may play a pacemaker role, as in the intestine. This study provide new information supporting the notion that the occurrence of oxidative stress in PE is not only related to endothelial dysfunction and apoptosis of the trophoblast cells, but also involves telocytes and its putative role in the regulation of fetal blood flow and the intra-placental blood volume. Some ideas aimed at dilucidating the relationship between placental failure and the behavior of telocytes in pathological organs in adulthood, are also discussed.
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Escudero C, Celis C, Saez T, San Martin S, Valenzuela F, Aguayo C, Bertoglia P, Roberts J, Acurio J. Increased placental angiogenesis in late and early onset pre-eclampsia is associated with differential activation of vascular endothelial growth factor receptor 2. Placenta 2014; 35:207-15. [DOI: 10.1016/j.placenta.2014.01.007] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2013] [Revised: 01/09/2014] [Accepted: 01/14/2014] [Indexed: 01/08/2023]
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Hale SA, Badger GJ, McBride C, Magness R, Bernstein IM. Prepregnancy Vascular Dysfunction in Women who Subsequently Develop Hypertension During Pregnancy. Pregnancy Hypertens 2013; 3:140-145. [PMID: 23772359 DOI: 10.1016/j.preghy.2013.01.006] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
OBJECTIVE To evaluate vascular dysfunction using both physiologic measures and biochemical markers, longitudinally, prior to and during pregnancy, in nulliparous women who had uncomplicated pregnancies compared to those who developed complicated hypertension during pregnancy. METHODS Twenty healthy nulliparous women were studied during the follicular phase and in early (EP) and late (LP) pregnancy. All had singleton conceptions and delivered at term, seventeen with uncomplicated pregnancies (NP) and three who developed complicated hypertension (HP) after the LP evaluation. We compared prepregnancy, EP and LP pulse wave velocity (PWV) and soluble vascular cell adhesion molecule (sVCAM-1) between the NP and HP groups. PWV was measured using ultrasound and simultaneous echocardiogram tracing then calculated as the estimated distance divided by interval between EKG r-wave peak and peak brachial artery flow. SVCAM-1 was measured using a commercially available kit. Data are means ± SE, significance accepted as p < 0.05. RESULTS The NP group had significantly lower prepregnant PWV (NP: 2.66 ± 0.06 m/s, HP: 3.00 ± 0.04, p=.02), but PWV was not different at the EP or LP time points. SVCAM-1 was significantly lower prior to pregnancy and during EP and LP in the NP group (Prepregnancy: NP: 712 ± 32 ng/mL, HP: 1058 ± 107, p < .001; EP: NP: 695 ± 31 ng/mL, HP: 924 ± 52, p = .004; LP: NP: 663 ± 25 ng/mL, HP: 946 ± 36, p < .001). CONCLUSIONS PWV and sVCAM-1 may be important prepregnancy discriminators useful in assessing risk for preeclampsia prior to pregnancy.
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Affiliation(s)
- Sarah A Hale
- Obstetrics, Gynecology and Reproductive Sciences, 89 Beaumont Ave, University of Vermont, Burlington, VT, United States, 05405
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Abstract
OBJECTIVE To determine the relationship between maternal ABO blood group and risk of adverse pregnancy outcomes. STUDY DESIGN Data on ABO phenotypes and pregnancy outcomes were collected from medical records of 5320 singleton pregnant women who had ABO blood testing and follow-up care until delivery in our institution. Adverse pregnancy outcomes that were studied in relation to maternal blood group included preeclampsia, gestational diabetes mellitus (GDM), preterm delivery, low birth weight (LBW) and small for gestational age (SGA) infants. RESULT Out of 5320 women, 350 (6.6%), 333 (6.3%) and 543 (10.2%) women were diagnosed with preeclampsia, GDM and preterm delivery, respectively. LBW and SGA were, respectively, observed in 394 (7.4%) and 178 (3.3%) infants. By uni- and multivariable analyses, women with A or AB blood types, but not B, were found at increased risk of preeclampsia compared with O type individuals; adjusted relative risks were 1.7 (95% confidence interval (CI), 1.3 to 2.3; P=0.001) for A phenotype and 1.7 (95% CI, 1.1 to 2.6; P=0.01) for AB phenotype. There were no significant relationships between blood types and GDM, preterm delivery, LBW or SGA. CONCLUSION Maternal ABO blood group was associated with the risk of preeclampsia, but not with GDM, preterm delivery, LBW or SGA.
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Mattoso CRS, Takahira RK, Beier SL, Araujo JP, Corrente JE. Evaluation of von Willebrand Factor During Pregnancy, Lactation and Oestrous Cycle in Bitches Affected and Unaffected by von Willebrand Disease. Reprod Domest Anim 2012; 48:416-22. [DOI: 10.1111/rda.12089] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2011] [Accepted: 08/25/2012] [Indexed: 11/29/2022]
Affiliation(s)
- CRS Mattoso
- School of Veterinary Medicine and Animal Science; São Paulo State University; Botucatu; São Paulo; Brazil
| | - RK Takahira
- School of Veterinary Medicine and Animal Science; São Paulo State University; Botucatu; São Paulo; Brazil
| | - SL Beier
- School of Veterinary Medicine, Agricultural and Animal Sciences Center; Santa Catarina State University; Lages; Santa Catarina; Brazil
| | - JP Araujo
- Biosciences Institute; São Paulo State University; Botucatu; São Paulo; Brazil
| | - JE Corrente
- Biosciences Institute; São Paulo State University; Botucatu; São Paulo; Brazil
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Bosco C, González J, Gutiérrez R, Parra-Cordero M, Barja P, Rodrigo R. Oxidative damage to pre-eclamptic placenta: immunohistochemical expression of VEGF, nitrotyrosine residues and von Willebrand factor. J Matern Fetal Neonatal Med 2012; 25:2339-45. [PMID: 22612323 DOI: 10.3109/14767058.2012.695823] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To determine the relationship of biomarkers of placental damage by oxidative stress in pre-eclamptic placenta. METHODS A case-control study was performed on a population of 14 pregnant women with PE and 12 women with normal pregnancies. Immunohistochemical expressions of VEGF, vWF distribution, (Na + K)-ATPase activity, and abundance of nitrotyrosine residues, were assessed in the placental tissue. RESULTS Women with pre-eclampsia showed increased VEGF expression and abundance of nitrotyrosine residues in placental villous, and plasma vWF levels (p < 0.05), whereas placental (Na + K)-ATPase activity were significantly reduced. The syncytiotrophoblast and the maternal space of pre-eclamptic placenta showed diminished and increased vWF expression, respectively, but no significant differences in its expression were found in the placental endothelium and stroma (p < 0.05). CONCLUSIONS It could be suggested that increased oxidative stress and VEGF contribute to enhance the impairment of placental perfusion by increasing peroxynitrite formation, product of the NO and superoxide reaction, thereby partly contributing to account for the pathophysiology of this disease. The presence of vWF in the maternal space and its diminished expression in syncytiotrophoblast of pre-eclamptic placenta also might have pathogenic implications.
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Affiliation(s)
- Cleofina Bosco
- Anatomy and Developmental Biology Programme, Institute of Biomedical Sciences, Faculty of Medicine, University of Chile, Santiago, Chile
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